{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T21:10:22Z","timestamp":1792789822360,"version":"4.5.0"},"reference-count":37,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2023,2,6]],"date-time":"2023-02-06T00:00:00Z","timestamp":1675641600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Italian Ministry of Health with Ricerca Corrente 2021 funds"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Very low-calorie ketogenic diets (VLCKD) are widely employed in successful weight-loss strategies. Herein, we evaluated the efficacy and safety of a VLCKD on non-alcoholic fatty liver disease (NAFLD) and parameters commonly associated with this condition in overweight and obese subjects who did not take any drugs. This prospective, real-life study included thirty-three participants who followed a VLCKD for 8 weeks. NAFLD was diagnosed using transient elastography (FibroScan). Data on anthropometric measurements, bioimpedance analysis, and biochemical assays were gathered both before and after the dietary intervention. BMI (kg\/m2) (from 33.84 \u00b1 6.55 to 30.89 \u00b1 6.38, p &lt; 0.01), waist circumference (cm) (from 106.67 \u00b1 15.51 to 98.64 \u00b1 16.21, p &lt; 0.01), and fat mass (Kg) (from 38.47 \u00b1 12.59 to 30.98 \u00b1 12.39, p &lt; 0.01) were significantly lower after VLCKD. CAP (db\/m), the FibroScan parameter quantifying fatty liver accumulation, showed a significant reduction after VLCKD (from 266.61 \u00b1 67.96 to 223 \u00b1 64.19, p &lt; 0.01). After VLCKD, the fatty liver index (FLI), a benchmark of steatosis, also revealed a significant decline (from 62.82 \u00b1 27.46 to 44.09 \u00b1 31.24, p &lt; 0.01). Moreover, fasting blood glucose, insulin, triglycerides, total cholesterol, LDL-cholesterol, ALT, \u03b3GT, and FT3 blood concentrations, as well as insulin resistance (quantified by HOMAIR) and systolic and diastolic blood pressure levels, were significantly lower after VLCKD (p &lt; 0.01 for all the parameters). By contrast, HDL-cholesterol, 25 (OH) vitamin D, and FT4 blood concentrations were higher after VLCKD (p &lt; 0.01 for all parameters). The variation (\u03b4) of CAP after VLCKD did not show a correlation with the \u03b4 of any other parameter investigated in this study. We conclude that VLCKD is a helpful approach for NAFLD independent of changes in factors commonly associated with NAFLD (obesity, fat mass, insulin resistance, lipids, and blood pressure) as well as vitamin D and thyroid hormone levels.<\/jats:p>","DOI":"10.3390\/nu15040825","type":"journal-article","created":{"date-parts":[[2023,2,6]],"date-time":"2023-02-06T05:29:05Z","timestamp":1675661345000},"page":"825","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":43,"title":["The Effects of Eight Weeks\u2019 Very Low-Calorie Ketogenic Diet (VLCKD) on Liver Health in Subjects Affected by Overweight and Obesity"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3817-8643","authenticated-orcid":false,"given":"Roberta","family":"Rinaldi","sequence":"first","affiliation":[{"name":"Unit of Geriatrics and Internal Medicine, National Institute of Gastroenterology \u201cSaverio de Bellis\u201d, IRCCS Hospital, Castellana Grotte, 70013 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"De Nucci","sequence":"additional","affiliation":[{"name":"Unit of Geriatrics and Internal Medicine, National Institute of Gastroenterology \u201cSaverio de Bellis\u201d, IRCCS Hospital, Castellana Grotte, 70013 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6439-8228","authenticated-orcid":false,"given":"Fabio","family":"Castellana","sequence":"additional","affiliation":[{"name":"Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology \u201cSaverio de Bellis\u201d, IRCCS Hospital, Castellana Grotte, 70013 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Di Chito","sequence":"additional","affiliation":[{"name":"Unit of Geriatrics and Internal Medicine, National Institute of Gastroenterology \u201cSaverio de Bellis\u201d, IRCCS Hospital, Castellana Grotte, 70013 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vito","family":"Giannuzzi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, National Institute of Gastroenterology \u201cSaverio de Bellis\u201d, IRCCS Hospital, Castellana Grotte, 70013 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4909-0436","authenticated-orcid":false,"given":"Endrit","family":"Shahini","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, National Institute of Gastroenterology \u201cSaverio de Bellis\u201d, IRCCS Hospital, Castellana Grotte, 70013 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9885-1185","authenticated-orcid":false,"given":"Roberta","family":"Zupo","sequence":"additional","affiliation":[{"name":"Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology \u201cSaverio de Bellis\u201d, IRCCS Hospital, Castellana Grotte, 70013 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9299-3211","authenticated-orcid":false,"given":"Luisa","family":"Lampignano","sequence":"additional","affiliation":[{"name":"Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology \u201cSaverio de Bellis\u201d, IRCCS Hospital, Castellana Grotte, 70013 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3221-6562","authenticated-orcid":false,"given":"Giuseppina","family":"Piazzolla","sequence":"additional","affiliation":[{"name":"Interdisciplinary Department of Medicine, School of Medicine, University of Bari \u201cAldo Moro\u201d, Piazza Giulio Cesare 11, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6308-0528","authenticated-orcid":false,"given":"Vincenzo","family":"Triggiani","sequence":"additional","affiliation":[{"name":"Interdisciplinary Department of Medicine, School of Medicine, University of Bari \u201cAldo Moro\u201d, Piazza Giulio Cesare 11, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raffaele","family":"Cozzolongo","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, National Institute of Gastroenterology \u201cSaverio de Bellis\u201d, IRCCS Hospital, Castellana Grotte, 70013 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianluigi","family":"Giannelli","sequence":"additional","affiliation":[{"name":"Scientific Direction, National Institute of Gastroenterology \u201cSaverio de Bellis\u201d, IRCCS Hospital, Castellana Grotte, 70013 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"De Pergola","sequence":"additional","affiliation":[{"name":"Unit of Geriatrics and Internal Medicine, National Institute of Gastroenterology \u201cSaverio de Bellis\u201d, IRCCS Hospital, Castellana Grotte, 70013 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,2,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2809","DOI":"10.1016\/j.cgh.2021.12.002","article-title":"2019 Global NAFLD Prevalence: A Systematic Review and Meta-analysis","volume":"20","author":"Le","year":"2021","journal-title":"Clin. 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